An estimated 61,560 Americans will receive a diagnosis of kidney cancer during 2015, according to a report released this year by the American Cancer Society. Death rates from kidney cancer dropped by about 1 percent per year between 2007 and 2011 but the disease is still expected to claim just over 14,000 American lives this year. Worldwide estimates for new kidney cancer cases among men were expected to be 213,900 in 2012, placing it among the top ten most diagnosed cancers for men that year.
The vast majority or kidney, or renal, cancer diagnoses are for renal cell carcinoma (RCC), a tumor that can exist in one or both kidneys and accounts for nine out of every 10 renal cancer diagnoses. Symptoms can include bloody urine and back pain. Even though a person can live with one kidney, kidney cancer does impact the kidney’s very important blood filtration and blood pressure control functions. Surgery is often used to remove kidney tumors up to and including Stage III, when a tumor has spread into large veins or nearby lymph nodes.
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Cancer is a complex disease that requires a multi-faceted medical response, so any improvement in treatment efficacy should be seen as a small yet important step towards greater control of tumor. That’s one reason why we were piqued to hear news that Bristol-Myers Squibb Co. (NYSE:BMY) was able to move on in clinical trials of its cancer drug Opvido more quickly than anticipated after kidney cancer patients who were administered the medication showed superior overall survival compared to those patients who were not on an Opvido regimen.
Opvido, which has already been approved by the U.S. Food and Drug Administration for the treatment of advanced melanomas and lung cancers, is an inhibitor of the protein known as programmed cell death protein 1, or PD-1. PD-1 inhibits the response of T cell lymphocytes, making it more difficult for an immune system to target a tumor. In the case of lung, kidney and melanoma cancers, Opvido was approved ahead of schedule for all three because of positive clinical trial results, indicating that PD-1 inhibition may have more extensive applications beyond these three cancers.
Bristol-Myers Squibb’s Opvido is not the only pharmaceutical product being developed to compete with Afinitor, a kidney cancer treatment created by Novartis AG (NYSE:NVS) of Basel, Switzerland. Genomics-based drug discovery firm Exelixis Inc. (NASDAQ:EXEL) of South San Francisco, CA, has been exploring the use of its cancer drug Cometriq as a second-line kidney cancer drug. Exelixis has reported that its Cometriq pharmaceutical improved progression-free survival rates for metastatic renal cancer patients by 42 percent over Afinitor. Near the end of July, Exelixis successfully ended a phase III clinical trial of Cometriq and will be submitting data from those trials to U.S. and European government agencies in early 2016 for drug approval. The trial results were very beneficial to Exelixis’s position on Wall Street, helping its stock jump by nearly 50 percent in the days following the good medical news. Overall, these targeted drugs, which owe a great deal of their efficacy to the research made in genomic medicine, have the ability to treat RCC and a variety of other cancers while producing far fewer side effects than typically result from a course of chemotherapy.
The positive returns for newcomers to the kidney cancer drug market is perhaps a sign that the market for these pharmaceutical treatments is shifting. Neither Bristol-Myers Squibb nor Exelixis is listed among the top five key vendors of kidney cancer treatments as reported by Markets and Research in its Global Kidney Cancer Drugs Market 2015-19 publication. According to the global market research firm, the drugs market for kidney cancer treatments is expected to grow at a compound annual growth rate of nearly 7.5 percent by 2019. Some of this increase stems from a growing worldwide prevalence of kidney cancer diagnoses due to multiple factors, including excessive smoking, alcohol drinking and sedentary lifestyles leading to obesity. New drugs for renal cell carcinoma are still entering the American market; at the end of July, the FDA announced that it had extended a “breakthrough therapy” designation to lenvatinib, marketed by Japanese drug developer Eisai Co., Ltd. (TYO:4523) under the name Lenvima, for use as a treatment against metastatic RCC. The designation doesn’t guarantee FDA approval but it does speed up the timeline that would put the pharmaceutical drug into the hands of those patients who could use it.
Often, the symptoms of kidney cancer do not present themselves until an advanced stage and any cancer becomes much more difficult to treat once it reaches Stage III or Stage IV. Advances in surgical technologies, however, may offer a new glimpse of hope for late stage cancer patients. Cryotherapy techniques have been developed by which argon gas is pumped directly into a kidney tumor, freezing it at temperatures of -40°F. The tumor is thawed and refrozen, destroying the cancerous tissue completely. This improves upon conventional surgical techniques which required removal of kidney tissue and tissue reconstruction to prevent leakage. The process also reduces the risk that a kidney can fail because it has had its blood supply shut off prior to surgery.
Surgery still remains the most common choice of treatment for removing tumors from a patient’s kidneys. A study published in the July 2015 edition of the monthly medical journal JAMA Surgery noted that, for patients at least 66 years of age who were diagnosed with kidney cancer during the 2000s, surgery was a treatment choice for 90 percent of those patients. When RCC and similar cancers are detected early, minimally invasive surgical procedures can successfully remove tumors while requiring the least amount of recovery time. Other technologies, such as fluorescent dyes for identifying tumor tissues, 3D imaging and robotic surgical techniques, can be coupled with minimally invasive surgeries for an even greater rate of success.